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Proposed outline of the pathway of tumor necrosis factor α (TNF-α) synthesis and effect of TNF-α on myocardial contractility. TNF-R: TNF-α receptor; MAPK: mitogen-activated protein kinase; NF-κB: nuclear factor kappaB; mRNA: messenger RNA; pro-TNF-α: TNF-α propeptide; cGMP: cyclic GMP; iNOS: inducible nitric oxide synthase; NO: nitric oxide.
